The Feasibility of a Positive Psychology Group Intervention for Patients with Multiple Sclerosis
Positive psychology (PP) uses targeted activities to increase the frequency and intensity of positive emotional experiences such as optimism. This intervention has successfully improved several patient reported outcomes (PROs) in healthy subjects as well as subjects with cardiovascular and other diseases, but it has not been used in multiple sclerosis (MS).
To evaluate the feasibility and tolerability of a five-week group PP training intervention and determine the impact of the intervention on optimism and positive affect in patients with MS.
Participants (n=11) were recruited from the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital, Partners MS Center (CLIMB). All participants were female and their ages ranged from 36-62 (mean=53). Subjects completed five weeks of group PP training in groups of 3-5. The PP activities included: gratitude for positive events, personal strengths, a gratitude letter, enjoyable and meaningful activities, and remembering past successes. Participants completed the exercises in between sessions, and the groups met once per week to discuss the exercises, with sessions lasting from 45-60 minutes. The primary outcome of the study was the proportion of subjects who completed the five weeks in order to measure feasibility and tolerability of the intervention. In addition, participants completed a battery of PROs pre and post intervention. The battery consisted of measures of optimism (LOT-R), positive and negative affect (PANAS), anxiety (STAI), depression (CES-D), and quality of life (SF-36). The change in the scores for each PRO was assessed using a paired t-test.
All participants completed the intervention (proportion completed=1; 95% CI: 0.72, 1), demonstrating the feasibility and tolerability of the intervention. For each PRO, the mean change showed a positive effect of the intervention. In particular, optimism, positive affect and quality of life were all observed to increase, while negative affect, depression and anxiety were all observed to decrease. Despite the constancy of the direction, only changes on the vitality subscale of the SF-36 (p=0.012) and the CES-D (p=0.049) were statistically significant.
Our study demonstrates that group PP is a feasible intervention that should be studied further in larger numbers of MS subjects.